Fujisaki S, Takayama T, Shimada K, Yamamoto J, Kosuge T, Yamasaki S, Tobisu K, Kurosu Y, Makuuchi M
First Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
Hepatogastroenterology. 1997 May-Jun;44(15):817-9.
The experience with hepatectomy for metastatic renal cell carcinoma (RCC) has been very rarely reported, because multiple organ metastases ordinarily coexist when hepatic metastases are found out. Three patients who underwent hepatectomy for metastatic RCC are presented here. Radical nephrectomy was performed for the primary renal lesions in all the patients, and their hepatic metastases were resected simultaneously in one of them with a solitary tumor, and about one month later in two of them with multiple (3 and 6) tumors. These operations produced no distinct complications. The patients with 1 and 3 hepatic metastatic lesions survived without tumor recurrence for 12 and 21 months, respectively, while the patient with 6 hepatic metastatic lesions had tumor-free interval of only 2 months and died 10 months after hepatectomy due to lung metastasis. Hepatectomy may be the only promising treatment for hepatic metastases from RCC, but the indication for surgery should be evaluated according to the number of hepatic metastases.
关于转移性肾细胞癌(RCC)肝切除术的经验报道极少,因为发现肝转移时通常已并存多器官转移。本文介绍了3例接受转移性RCC肝切除术的患者。所有患者均对原发性肾脏病变进行了根治性肾切除术,其中1例有单个肿瘤的患者同时切除了肝转移灶,另外2例有多个(3个和6个)肿瘤的患者在约1个月后进行了肝转移灶切除。这些手术未产生明显并发症。有1个和3个肝转移灶的患者分别无肿瘤复发存活了12个月和21个月,而有6个肝转移灶的患者无瘤间期仅2个月,肝切除术后10个月因肺转移死亡。肝切除术可能是RCC肝转移唯一有前景的治疗方法,但手术指征应根据肝转移灶数量进行评估。